中风与神经疾病杂志2026，Vol.43Issue(5)：399-402,4.DOI:10.19845/j.cnki.zfysjjbzz.2026.0068
双侧苍白球内侧部电刺激术作为丘脑底核电刺激术治疗帕金森病失效后挽救性治疗策略的可行性研究
Feasibility of bilateral globus pallidus internus deep brain stimulation as a rescue treatment strategy after failed subthalamic nucleus deep brain stimulation for Parkinson disease
王若曦 1张文强 2刘文卿 3卜维婷 3邬宗宪 1苏道庆4
作者信息
- 1. 山东第二医科大学,山东 潍坊 261053
- 2. 山东第一医科大学,山东 济南 250117
- 3. 山东第一医科大学附属中心医院,山东 济南 250101||首都医科大学宣武医院济南医院脑机接口创新中心、运动障碍与神经疼痛中心,山东 济南 250101
- 4. 山东第二医科大学,山东 潍坊 261053||山东第一医科大学,山东 济南 250117||山东第一医科大学附属中心医院,山东 济南 250101||首都医科大学宣武医院济南医院脑机接口创新中心、运动障碍与神经疼痛中心,山东 济南 250101
- 折叠
摘要
Abstract
Objective To investigate the feasibility and efficacy of bilateral globus pallidus internus deep brain stimulation(GPi-DBS)as a rescue treatment strategy after failed subthalamic nucleus deep brain stimulation(STN-DBS)in the management of Parkinson disease(PD).Methods A retrospective analysis was conducted on two patients who had undergone STN-DBS treatment at another hospital for Parkinson's disease(PD)but showed poor therapeutic response.Af-ter evaluation at the Central Hospital affiliated with Shandong First Medical University confirmed that efficacy could not be restored through parameter optimization or medication adjustment,both patients underwent a procedure to retain their original STN-DBS system and implant bilateral GPi-DBS systems.Following the deactivation of the STN-DBS,surgical outcomes were assessed by comparing preoperative and postoperative Unified Parkinson's Disease Rating Scale Part Ⅲ(UPDRS-Ⅲ)scores under conditions of active GPi-DBS,as well as during"on"and"off"medication periods.Results Both patients successfully retained their original STN-DBS systems and underwent uneventful implantation of bi-lateral GPi-DBS systems,without complications such as bleeding or infection.Six months postoperatively,Patient 1 showed a UPDRS-Ⅲ improvement rate of 61.21%during the"on"medication phase and 68.92%during the"off"medica-tion phase with GPi-DBS activated.Patient 2 demonstrated an improvement rate of 55.81%during the"on"medication phase and 59.34%during the"off"medication phase under GPi-DBS activation.Both patients exhibited significant im-provements in dyskinesia,speech,and balance.Conclusion Retaining the original STN system with simultaneous bilat-eral GPi-DBS reimplantation may be a safe and effective rescue treatment strategy for PD patients who experience a decline in efficacy or severe complications following STN-DBS surgery that cannot be improved by optimizing medication or pro-gramming parameters.关键词
帕金森病/脑深部电刺激术/苍白球内侧部/丘脑底核/挽救性治疗Key words
Parkinson disease/Deep brain stimulation/Globus pallidus internus/Subthalamic nucleus/Salvage therapy分类
医药卫生引用本文复制引用
王若曦,张文强,刘文卿,卜维婷,邬宗宪,苏道庆..双侧苍白球内侧部电刺激术作为丘脑底核电刺激术治疗帕金森病失效后挽救性治疗策略的可行性研究[J].中风与神经疾病杂志,2026,43(5):399-402,4.
